128 died of black fungus in Mumbai hospitals since Feb

A total of 128 of the 741 diagnosed with mucormycosis or black fungus, since the start of the second Covid-19 wave in February, have died in city hospitals

A total of 128 of the 741 diagnosed with mucormycosis or black fungus, since the start of the second Covid-19 wave in February, have died in city hospitals. Forty of the victims were from Mumbai, data shows.

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Mucormycosis is a serious, but rare fungal infection caused by a group of moulds called mucormycetes. According to doctors, it causes blindness, organ dysfunction, loss of body tissue and can be fatal, if not treated in time.

“As the city has several tertiary-care super speciality hospitals that are well-equipped to provide timely treatment to patients who need surgical and medical intervention, we get a large number of patients from outside the city. So far, we have recorded 128 deaths due to mucormycosis in the city, but most of the deceased are from outside Mumbai,” said Suresh Kakani, additional commissioner, Brihanmumbai Municipal Corporation (BMC).

Doctors said most patients from outside Mumbai delay their treatment for mucormycosis (which has an overall mortality rate of 50%), contributing to the fatality rate. “Compared to the first wave of the coronavirus pandemic, there have been more cases of black fungus in the second wave. Most of the patients we receive come in by the time the fungus generally spreads furthermore, including the brain,” said Dr Renuka Bradoo, head of department of ear, nose, throat (ENT), Lokmanya Tilak General Hospital, which is also known as Sion Hospital. In May, the hospital recorded around 33% mortality rate.

However, with the flattening of the pandemic curve, the number of daily admission of patients with mucormycosis has fallen by almost 40% at major civic-run hospitals. Dr Ramesh Bharmal, dean of BYL Nair Hospital, said, “The daily Covid-19 cases started declining from May, so fewer patients are developing post-Covid complications like mucormycosis. The daily admission has dropped to a great extent compared to April.”

Currently, 384 active mucormycosis patients are undergoing treatment in Mumbai. Of this, 274 patients are from outside Mumbai and 110 patients are residents of the city. Most patients need three-four weeks for complete recovery. Some patients are kept longer to check on the possible regrowth or further spread of black fungus in other parts of the body. For instance, at present, 112 patients with mucormycosis are undergoing treatment at King Edward Memorial (KEM) Hospital, Parel, which has special wards for fungal treatment. “The treatment takes longer than Covid-19 as they require hospitalisation and surgery. Only 10% of the admitted patients get discharged after full recovery,” said Dr Hetal Marfatia, head of the department, ENT.

According to a guideline issued on May 17 by the state’s commissioner of health services and mission director, National Health Mission (NHM), patients with high blood sugar, if required, need to be examined by an ENT specialist for symptoms of mucormycosis. If needed, the patients can also be examined by an ophthalmologist. “The immunity gets compromised in a Covid-19 patient due to some medicines like Tocilizumab and steroids. So when they get exposed to mucor mold, which is commonly found in soil, plants, manure, and decaying fruits and vegetables, it becomes life threatening. It affects the sinuses, brain and lungs,” said Dr Girija Suresh, senior ophthalmic consultant, Fortis Hospital, Mulund.

Steroids reduce inflammation in the lungs of Covid-19 infected patients. But it also reduces the immunity and increases the blood sugar levels in the Covid-19 patients. Dr Ajay Doiphode, president, Association of Otolaryngologists (AOI), blamed unregulated usages of steroids that lowers the immunity in the body as one of the primary reasons for the surge in cases.